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[PMID]:29414988
[Au] Autor:Morgan SJ; McDonald CL; Halsne EG; Cheever SM; Salem R; Kramer PA; Hafner BJ
[Ad] Endereço:Department of Rehabilitation Medicine, University of Washington, Seattle, WA, United States of America.
[Ti] Título:Laboratory- and community-based health outcomes in people with transtibial amputation using crossover and energy-storing prosthetic feet: A randomized crossover trial.
[So] Source:PLoS One;13(2):e0189652, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Contemporary prosthetic feet are generally optimized for either daily or high-level activities. Prosthesis users, therefore, often require multiple prostheses to participate in activities that span a range of mobility. Crossover feet (XF) are designed to increase the range of activities that can be performed with a single prosthesis. However, little evidence exists to guide clinical prescription of XF relative to traditional energy storing feet (ESF). The objective of this study was to assess the effects of XF and ESF on health outcomes in people with transtibial amputation. A randomized crossover study was conducted to assess changes in laboratory-based (endurance, perceived exertion, walking performance) and community-based (step activity and self-reported mobility, fatigue, balance confidence, activity restrictions, and satisfaction) outcomes. Twenty-seven participants were fit with XF and ESF prostheses with standardized sockets, interfaces, and suspensions. Participants were not blinded to the intervention, and wore each prosthesis for one month while their steps were counted with an activity monitor. After each accommodation period, participants returned for data collection. Endurance and perceived exertion were measured with the Six-Minute Walk Test and Borg-CR100, respectively. Walking performance was measured using an electronic walkway. Self-reported mobility, fatigue, balance confidence, activity restrictions, and satisfaction were measured with survey instruments. Participants also reported foot preferences upon conclusion of the study. Differences between feet were assessed with a crossover analysis. While using XF, users experienced improvements in most community-based outcomes, including mobility (p = .001), fatigue (p = .001), balance confidence (p = .005), activity restrictions (p = .002), and functional satisfaction (p < .001). Participants also exhibited longer sound side steps in XF compared to ESF (p < .001). Most participants (89%) reported an overall preference for XF; others (11%) reported no preference. Results indicate that XF may be a promising alternative to ESF for people with transtibial amputation who engage in a range of mobility activities. TRIAL REGISTRATION: ClinicalTrials.gov NCT02440711.
[Mh] Termos MeSH primário: Amputação
Membros Artificiais

Próteses e Implantes
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Estudos Cross-Over
Seres Humanos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180208
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189652


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[PMID]:28456893
[Au] Autor:Kanazawa M; Tsuru K; Fukuda N; Sakemi Y; Nakashima Y; Ishikawa K
[Ad] Endereço:Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
[Ti] Título:Evaluation of carbonate apatite blocks fabricated from dicalcium phosphate dihydrate blocks for reconstruction of rabbit femoral and tibial defects.
[So] Source:J Mater Sci Mater Med;28(6):85, 2017 Jun.
[Is] ISSN:1573-4838
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study aimed to evaluate in vivo behavior of a carbonate apatite (CO Ap) block fabricated by compositional transformation via a dissolution-precipitation reaction using a calcium hydrogen phosphate dihydrate [DCPD: CaHPO ·2H O] block as a precursor. These blocks were used to reconstruct defects in the femur and tibia of rabbits, using sintered dense hydroxyapatite (HAp) blocks as the control. Both the CO Ap and HAp blocks showed excellent tissue response and good osteoconductivity. HAp block maintained its structure even after 24 weeks of implantation, so no bone replacement of the implant was observed throughout the post-implantation period in either femoral or tibial bone defects. In contrast, CO Ap was resorbed with increasing time after implantation and replaced with new bone. The CO Ap block was resorbed approximately twice as fast at the metaphysis of the proximal tibia than at the epiphysis of the distal femur. The CO Ap block was resorbed at an approximately linear change over time, with complete resorption was estimated by extrapolation of data at approximately 1-1.5 years. Hence, the CO Ap block fabricated in this study has potential value as an ideal artificial bone substitute because of its resorption and subsequent replacement by bone.
[Mh] Termos MeSH primário: Apatitas/química
Substitutos Ósseos
Fosfatos de Cálcio/química
[Mh] Termos MeSH secundário: Animais
Durapatita
Epífises
Fêmur
Próteses e Implantes
Coelhos
Tíbia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Apatites); 0 (Bone Substitutes); 0 (Calcium Phosphates); 55326-60-8 (carboapatite); 91D9GV0Z28 (Durapatite); O7TSZ97GEP (calcium phosphate, dibasic, dihydrate)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE
[do] DOI:10.1007/s10856-017-5896-5


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[PMID]:29390376
[Au] Autor:Han SB; Kyung HS; Seo IW; Shin YS
[Ad] Endereço:Department of Orthopedic Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul.
[Ti] Título:Better clinical outcomes after unicompartmental knee arthroplasty when comparing with high tibial osteotomy.
[So] Source:Medicine (Baltimore);96(50):e9268, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Both high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are well-established treatments for medial knee osteoarthritis (OA). However, it is unclear whether HTO or UKA leads to better clinical outcomes and lower complication rates. This meta-analysis compared the clinical outcomes and complications of HTO and UKA in patients with medial knee OA. METHODS: All studies comparing the functional outcome, postoperative pain, revision rate to total knee arthroplasty (TKA), postoperative complications, postoperative velocity, and postoperative range of motion (ROM) as assessed with various measurement tools in patients with medial knee OA treated with HTO or UKA were included. RESULTS: Sixteen studies were included in the meta-analysis. The proportion of patients who underwent revision to TKA (OR 1.56, 95% CI: 0.61-3.98; P = .35) did not differ significantly between HTO and UKA. In contrast, functional outcome (OR 0.47, 95% CI: 0.24 to 0.95; P = .04), postoperative pain (OR 0.28, 95% CI: 0.12 to 0.62; P = .002), postoperative complications (OR 2.48, 95% CI: 1.26 to 4.90; P = .009), postoperative velocity (95% CI: -0.11 to -0.00; P = .03), and postoperative ROM (95% CI: 2.02 to 15.23; P = .01) were significantly different between the 2 groups. CONCLUSIONS: There were no significant differences in the revision rate to TKA between HTO and UKA. However, results from subgroup analyses suggested that opening-wedge HTO resulted in a lower revision rate to TKA than did UKA, whereas closing-wedge HTO resulted in a higher revision rate to TKA than did UKA. In addition, UKA resulted in significantly better functional outcomes and postoperative velocity, along with less postoperative pain, fewer postoperative complications, and lower postoperative ROM. Based on the findings of current meta-analysis, UKA appears to be as efficacious and safe as HTO in the treatment of medial knee OA.
[Mh] Termos MeSH primário: Artroplastia do Joelho/métodos
Osteoartrite do Joelho/cirurgia
Osteotomia/métodos
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Amplitude de Movimento Articular
Reoperação
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009268


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[PMID]:29465573
[Au] Autor:Li X; Zhang Z; Latif M; Chen W; Cui J; Peng Z
[Ad] Endereço:Department of Radiology, the Third Hospital of Hebei Medical University.
[Ti] Título:Synovium as a widespread pathway to the adjacent joint in undifferentiated high-grade pleomorphic sarcoma of the tibia: A case report.
[So] Source:Medicine (Baltimore);97(8):e9870, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Undifferentiated high-grade pleomorphic sarcoma (UPS), originated from bone, is a rare tumor, accounting for 2% to 5% of all primary maligment bone neoplasms. Skip lesion can be found in undifferentiated high-grade pleomorphic sarcoma of bone (UPS-B). However, the direct invasion across the articular synovium to bone has not been reported previously. PATIENT CONCERNS: We report an unusual case of a 65-year-old man complained of a year history of pain, swelling, and limitation of activity in the left knee joint. At the proximal tibia, there was extensive invasion of articular synovium, which provides a direct anatomic pathway for the tumor invasion to the adjacent bone, including patella and femoral condyle. DIAGNOSES: Magnetic resonance imaging was important in defining the marrow involvement and joint invasion, including the thickening articular synovium. Subsequent pathological examination confirmed the diagnosis of UPS. INTERVENTIONS: The patient underwent an extensive resection of the knee joint, except for the patellar. OUTCOMES: After operation, routine chemotherapy was performed. Unfortunately, half a year later, soft tissue swelling of whole thigh was found. Then this patient came our hospital again. Positron emission tomography imaging showed there was recurrence of UPS with lung metastasis. A week later, this patient died. LESSONS: In contrast to frequent infiltration pathway, the articular synovium as a media for this tumor spread is rare. This study adds a better understanding of this direct invasion way to the medical literature.
[Mh] Termos MeSH primário: Neoplasias Ósseas/patologia
Histiocitoma Fibroso Maligno/patologia
Membrana Sinovial/patologia
Tíbia/patologia
[Mh] Termos MeSH secundário: Idoso
Neoplasias Ósseas/diagnóstico por imagem
Neoplasias Ósseas/cirurgia
Evolução Fatal
Neoplasias Femorais/diagnóstico por imagem
Neoplasias Femorais/patologia
Neoplasias Femorais/cirurgia
Histiocitoma Fibroso Maligno/diagnóstico por imagem
Histiocitoma Fibroso Maligno/cirurgia
Seres Humanos
Articulação do Joelho/diagnóstico por imagem
Articulação do Joelho/patologia
Articulação do Joelho/cirurgia
Neoplasias Pulmonares/secundário
Imagem por Ressonância Magnética
Masculino
Invasividade Neoplásica
Patela/diagnóstico por imagem
Patela/patologia
Patela/cirurgia
Membrana Sinovial/diagnóstico por imagem
Coxa da Perna/diagnóstico por imagem
Coxa da Perna/patologia
Tíbia/diagnóstico por imagem
Tíbia/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009870


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[PMID]:29364934
[Au] Autor:Christen P; Boutroy S; Ellouz R; Chapurlat R; van Rietbergen B
[Ad] Endereço:Institute for Biomechanics, ETH Zurich, Zurich, Switzerland.
[Ti] Título:Least-detectable and age-related local in vivo bone remodelling assessed by time-lapse HR-pQCT.
[So] Source:PLoS One;13(1):e0191369, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We previously developed an image analysis approach for the determination of local sites of bone remodelling using time-lapse in vivo HR-pQCT. The involved image filtering for removing noise was chosen rather aggressively, and also removed some effects of the bone remodelling. In this paper, we quantify these filtering settings using ex vivo reproducibility HR-pQCT images, and determine the least-detectable bone remodelling using in vivo reproducibility HR-pQCT images, as well as testing whether the approach is capable of capturing age-related bone remodelling by use of in vivo long-term HR-pQCT images. We found that a threshold value of 225 mg HA/cm3 for the filtering led to acceptable results with falsely determined bone remodelling of less than 0.5%, and that the least-detectable bone formation and bone resorption are 2.0 ± 1.0% and 2.2 ± 0.7% respectively. We also found that age-related local bone remodelling can be captured satisfactorily in postmenopausal women. The latter revealed new insights into the effect of ageing on bone remodelling, and showed that bone remodelling seems to take place through a few small formation packets and many large resorption volumes leading to a net bone loss. We conclude that local in vivo bone remodelling can be successfully assessed with time-lapse in vivo HR-pQCT capable of assessing age-related changes in bone remodelling.
[Mh] Termos MeSH primário: Remodelação Óssea/fisiologia
Osso e Ossos/diagnóstico por imagem
Imagem com Lapso de Tempo/métodos
Tomografia Computadorizada por Raios X/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Cadáver
Feminino
Seguimentos
Seres Humanos
Imagem Tridimensional/métodos
Masculino
Meia-Idade
Rádio (Anatomia)/diagnóstico por imagem
Reprodutibilidade dos Testes
Tíbia/diagnóstico por imagem
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191369


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[PMID]:29329344
[Au] Autor:Russell Esposito E; Miller RH
[Ad] Endereço:Center for the Intrepid, Brooke Army Medical Center, Department of Rehabilitation Medicine, JBSA, Ft. Sam Houston, Texas, United States of America.
[Ti] Título:Maintenance of muscle strength retains a normal metabolic cost in simulated walking after transtibial limb loss.
[So] Source:PLoS One;13(1):e0191310, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Recent studies on relatively young and fit individuals with limb loss suggest that maintaining muscle strength after limb loss may mitigate the high metabolic cost of walking typically seen in the larger general limb loss population. However, these data are cross-sectional and the muscle strength prior to limb loss is unknown, and it is therefore difficult to draw causal inferences on changes in strength and gait energetics. Here we used musculoskeletal modeling and optimal control simulations to perform a longitudinal study (25 virtual "subjects") of the metabolic cost of walking pre- and post-limb loss (unilateral transtibial). Simulations of walking were first performed pre-limb loss on a model with two intact biological legs, then post-limb loss on a model with a unilateral transtibial prosthesis, with a cost function that minimized the weighted sum of gait deviations plus metabolic cost. Metabolic costs were compared pre- vs. post-limb loss, with systematic modifications to the muscle strength and prosthesis type (passive, powered) in the post-limb loss model. The metabolic cost prior to limb loss was 3.44±0.13 J/m/kg. After limb loss, with a passive prosthesis the metabolic cost did not increase above the pre-limb loss cost if pre-limb loss muscle strength was maintained (mean -0.6%, p = 0.17, d = 0.17). With 10% strength loss the metabolic cost with the passive prosthesis increased (mean +5.9%, p < 0.001, d = 1.61). With a powered prosthesis, the metabolic cost was at or below the pre-limb loss cost for all subjects with strength losses of 10% and 20%, but increased for all subjects with strength loss of 30% (mean +5.9%, p < 0.001, d = 1.59). The results suggest that maintaining muscle strength may prevent an increase in the metabolic cost of walking following unilateral transtibial limb loss, and that a gait with minimal deviations can be achieved when muscle strength is sufficiently high, even when using a passive prosthesis.
[Mh] Termos MeSH primário: Amputados
Membros Artificiais
Força Muscular
Tíbia
Caminhada/fisiologia
[Mh] Termos MeSH secundário: Seres Humanos
Modelos Biológicos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191310


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[PMID]:28455292
[Au] Autor:Harrold E; McMahon E; McGing P; Higgins M
[Ad] Endereço:Mater Misericordiae University Hospital, Dublin, Ireland.
[Ti] Título:ßhCG-secreting osteosarcoma.
[So] Source:BMJ Case Rep;2017, 2017 Apr 28.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:A 35-year-old woman presented to our institution with tender, right knee swelling. Radiological and pathological work-up revealed metastatic osteosarcoma. Prior to the initiation of chemotherapy, she underwent a routine urine pregnancy test and was surprised with a positive result. Serum beta human chorionic gonadotropin (ßhCG) levels were also consistently positive and rising. No gestational sac was seen at transvaginal ultrasound. The paraneoplastic ectopic secretion of ßhCG has been well described in gestational trophoblastic and gonadal tumours but has very rarely been associated with other tumour types. This patient's ßhCG level was reflective of osteosarcoma activity and normalised with response to chemotherapy. The prognostic implications of ßhCG expression in more diverse tumours is unclear; however, where raised, it can be used to monitor disease activity.
[Mh] Termos MeSH primário: Gonadotropina Coriônica Humana Subunidade beta/sangue
Joelho/diagnóstico por imagem
Osteossarcoma/sangue
Osteossarcoma/secundário
[Mh] Termos MeSH secundário: Adulto
Assistência ao Convalescente
Gonadotropina Coriônica Humana Subunidade beta/secreção
Feminino
Seres Humanos
Joelho/patologia
Osteossarcoma/patologia
Osteossarcoma/terapia
Dor/diagnóstico
Dor/etiologia
Testes de Gravidez
Prognóstico
Tíbia/patologia
Tíbia/cirurgia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Chorionic Gonadotropin, beta Subunit, Human)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE


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[PMID]:29437058
[Au] Autor:Lam Tin Cheung K; Lanting BA; McCalden RW; Yuan X; MacDonald SJ; Naudie DD; Teeter MG
[Ad] Endereço:Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, Ontario N6A 5C1, Canada.
[Ti] Título:Inducible displacement of cemented tibial components ten years after total knee arthroplasty.
[So] Source:Bone Joint J;100-B(2):170-175, 2018 Feb.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: The aim of this study was to evaluate the long-term inducible displacement of cemented tibial components ten years after total knee arthroplasty (TKA). PATIENTS AND METHODS: A total of 15 patients from a previously reported prospective trial of fixation using radiostereometric analysis (RSA) were examined at a mean of 11 years (10 to 11) postoperatively. Longitudinal supine RSA examinations were acquired at one week, one year, and two years postoperatively and at final follow-up. Weight-bearing RSA examinations were also undertaken with the operated lower limb in neutral and in maximum internal rotation positions. Maximum total point motion (MTPM) was calculated for the longitudinal and inducible displacement examinations (supine standing, standing internal rotation, and supine standing with internal rotation). RESULTS: All patients showed some inducible displacement. Two patients with radiolucent lines had greater mean standing-supine MTPM displacement (1.35; sd 0.38) compared with the remaining patients (0.68; sd 0.36). These two patients also had a greater mean longitudinal MTPM at ten years (0.64; sd 0.50) compared with the remaining patients (0.39; sd 0.13 mm). CONCLUSION: Small inducible displacements in well-fixed cemented tibial components were seen ten years postoperatively, of a similar magnitude to that which has been reported for well-fixed components one to two years postoperatively. Greater displacements were found in components with radiolucent lines. Cite this article: 2018;100-B:170-5.
[Mh] Termos MeSH primário: Artroplastia do Joelho
Prótese do Joelho
Falha de Prótese
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Estudos Longitudinais
Masculino
Meia-Idade
Postura
Estudos Prospectivos
Desenho de Prótese
Análise Radioestereométrica
Suporte de Carga
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180214
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B2.BJJ-2017-0428.R2


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[PMID]:29252746
[Au] Autor:Pace JL; Pérez-López LM
[Ad] Endereço:Children's Orthopedic Center, Children's Hospital Los Angeles, Los Angeles, California.
[Ti] Título:Indicative Knee Posture in Children with Osteomyelitis of the Proximal Part of the Tibia with or without an Associated Subperiosteal Abscess: A Report of 3 Cases.
[So] Source:JBJS Case Connect;6(4):e92, 2016 Oct-Dec.
[Is] ISSN:2160-3251
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CASE: Three patients with documented osteomyelitis of the proximal part of the tibia are described. On examination, all of the patients had an indicative finding of knee flexion to 90°. Because of the concern for septic arthritis, each patient underwent knee aspiration as part of the evaluation.All recovered with conventional infection treatment protocols. CONCLUSION: High knee flexion beyond what is typical in patients with septic arthritis may indicate osteomyelitis of the proximal part of the tibia. Consideration of this diagnosis may lead to more expedient and efficient care.
[Mh] Termos MeSH primário: Artrite Infecciosa/diagnóstico
Articulação do Joelho/fisiopatologia
Osteomielite/diagnóstico
Tíbia/diagnóstico por imagem
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Feminino
Seres Humanos
Masculino
Osteomielite/fisiopatologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.CC.15.00255


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[PMID]:29381938
[Au] Autor:Ye C; Lai Q; Zhang S; Gao T; Zeng J; Dai M
[Ad] Endereço:Department of Orthopedics, The First Affiliated Hospital of Nanchang University. Artificial Joints Engineering and Technology Research Center of Jiangxi Province, Nanchang, Jiangxi, China.
[Ti] Título:Osteopoikilosis found incidentally in a 17-year-old adolescent with femoral shaft fracture: A case report.
[So] Source:Medicine (Baltimore);96(47):e8650, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Osteopoikilosis is a rare and asymptomatic disease of the bone, which is often discovered occasionally on radiography for irrelevant complaints. Characterized by multiple, small, circular, or oval-shaped radiodense lesions, it may be confused with bony metastatic tumors. PATIENT CONCERNS: The present study describes a case of a 17-year-old adolescent who suffered from pain and movement limitation of his left thigh following a fall from standing height. DIAGNOSES: Plain radiographs showed spiral fracture in left femoral shaft; besides, multiple scattered sclerotic lesions of variable size were also observed over the bilateral proximal femurs, left distal femur, proximal tibia, and distal tibia and fibula through X-rays, computed tomography, and magnetic resonance imaging. The patient was finally diagnosed with left femoral shaft fracture and osteopoikilosis. INTERVENTIONS: The patient underwent reduction and internal fixation with intramedullary nail a week after injury. OUTCOMES: The patient was discharged without any complications 12 days after the surgery. At the 3-month follow-up, the patient recovered well and remained symptom-free with no changes to his sclerotic lesions. LESSONS: Although this case is not so complicated, we have to be cautious when differentiating osteopoikilosis and bony metastases in clinical practice in future, which should avoid causing undue distress to both the patients and doctors.
[Mh] Termos MeSH primário: Fraturas do Fêmur/diagnóstico
Fêmur
Fíbula/diagnóstico por imagem
Neoplasias de Tecido Ósseo/diagnóstico
Osteopecilose/diagnóstico
Radiografia/métodos
Tíbia/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adolescente
Diagnóstico Diferencial
Fraturas do Fêmur/cirurgia
Fêmur/diagnóstico por imagem
Fêmur/lesões
Fixação Intramedular de Fraturas/métodos
Seres Humanos
Achados Incidentais
Imagem por Ressonância Magnética/métodos
Masculino
Tomografia Computadorizada por Raios X/métodos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008650



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